Tracy, Keith T

Tracy, Keith T is an individual health care provider with primary practice located at 780 Main St , S Weymouth MA 02190-1622. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Tracy, Keith T can be contacted via phone (781) 331-4600.

Contact Information

Primary practice address
780 Main St S Weymouth MA 02190-1622
Phone: (781) 331-4600
Fax: (781) 337-5095
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 227369 Massachusetts

Profile Details

NPI number 1477511871
LBN Legal business name Tracy, Keith T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jan 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477511871 NPPES
Massachusetts MEDICAID 2119561
Massachusetts Other AA62481
Massachusetts Other 494983
Massachusetts Other 1238590
Massachusetts Other J40295
Massachusetts Other 116191
Massachusetts Other 1847716

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